This chapter reviews the changes in pedophilia as a sexual orientation that have
been achieved and describes how therapeutic changes in the sexual responses
of pedophiles have been integrated into a comprehensive cognitive-behavioral
treatment involving relapse prevention. Before we begin, it will be helpful to
define some terms here and to provide a disclaimer. In 1973, the American
Psychiatric Association removed homosexuality from its Diagnostic and Statistical Manual of Mental Disorders (DSM-II:
American Psychiatric Association 1973), thereby conveying its disagreement with the illness model of homosexuality. Since then there has been widespread rejection of the illness model,
reflected in a 1975 resolution of the American Psychological Association encouraging its members to provide leadership in counteracting the stigma attached
to homosexuality. As a consequence, there have been strong ethical objections
raised about attempts to convert homosexuals to heterosexuality ( Haldeman 1994). The ethical arguments are twofold. First, it is unethical to attempt to cure
a condition that is not judged to be an illness. Second, attempts to "cure"
homosexual orientation reinforce the prejudicial and unjustified devaluation of
homosexuals ( Haldeman 1994). This chapter supports the anti-illness view of
homosexuality, and the methods described here for achieving change in sexual
orientation are not presented in any way as a promotion of attempts to change
homosexual orientation. Nevertheless, attempts to change homosexuality have
historical interest since later attempts to change pedophilia and other paraphilias
were based on earlier work with homosexuals.

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